The present disclosure relates generally to devices for treatment of cancers. More particularly, the present disclosure relates to devices for brachytherapy treatment of cancers in the vaginal, vulvar, anal and urethral regions.
Cancers in the vaginal, vulvar, anal and urethral regions, which include recurrent endometrial and cervical cancers, usually spread into the abdominal wall and are difficult to reach. Many physicians thus use a laparotomy to reach the tumor site. In this procedure, a large incision is made through the abdominal wall to gain access into the abdominal cavity. Needles that are to deliver the radiotherapy are then placed through the tumor via the abdominal side and the vaginal side of the tumor. This method requires inpatient status and is invasive.
Interstitial brachytherapy allows for radioactive implants to be placed directly into the tumor. This form of brachytherapy is usually reserved for patients that have extensive pelvic and/or vaginal disease in an attempt to improve local control or those patients with anatomy that does not allow for intracavitary brachytherapy with standard applicators (for example, patients having had a hysterectomy, narrow vagina, etc).
Devices such as the Syed-Neblett template are commonly used for interstitial brachytherapy treatment of primary vaginal, vulvar, cervix and urethral cancers. The Syed-Neblett template consists of two superimposed heavy plastic plates held together by metallic screws. The Syed-Neblett template is sutured in place on the perineum. Pre-drilled holes in the template accept the needles that are guided to and ultimately placed within the tumor. A large hole in the middle of the template allows for insertion of radiation sources. Because of the heavy plastic and metallic screws, the Syed-Neblett template may elicit pain in the patient that requires epidural treatment for pain management, and thus, inpatient status.
While the devices are suitable for placing radioactive implants directly into the tumor, they can require surgery and require inpatient status. Accordingly, there exists a need to develop devices and non-invasive methods for delivering radiotherapy in a manner that allows patients to be treated on an outpatient basis and without requiring surgery.